The effect of hospital ownership on quality of care: evidence from England.

TY - UNPB

T1 - The effect of hospital ownership on quality of care

T2 - evidence from England.

AU - Moscelli, Giuseppe

AU - Gravelle, Hugh Stanley Emrys

AU - Siciliani, Luigi

AU - Gutacker, Nils

PY - 2017/3

Y1 - 2017/3

N2 - We investigate whether quality of care differs between public and private hospitals in England with data on 3.8 million publicly-funded patients receiving 133 planned (non-emergency) treatments in 393 public and 190 private hospitalsites. Private hospitals treat patients with fewer comorbidities and pasthospitalisations. Controlling for observed patient characteristics and treatment type, private hospitals have fewer emergency readmissions. Conversely, after instrumenting the choice of hospital type by the difference in distances from the patient to the nearest public and the nearest private hospital, the effect of ownership is smaller and statistically insignificant. Similar results are obtained with coarsened exact matching. We also find no quality differences between hospitals specialising in planned treatments and other hospitals, nor between for-profit and not-for-profit private hospitals. Our results show the importance of controlling for unobserved patient heterogeneity when comparing quality ofpublic and private hospitals.

AB - We investigate whether quality of care differs between public and private hospitals in England with data on 3.8 million publicly-funded patients receiving 133 planned (non-emergency) treatments in 393 public and 190 private hospitalsites. Private hospitals treat patients with fewer comorbidities and pasthospitalisations. Controlling for observed patient characteristics and treatment type, private hospitals have fewer emergency readmissions. Conversely, after instrumenting the choice of hospital type by the difference in distances from the patient to the nearest public and the nearest private hospital, the effect of ownership is smaller and statistically insignificant. Similar results are obtained with coarsened exact matching. We also find no quality differences between hospitals specialising in planned treatments and other hospitals, nor between for-profit and not-for-profit private hospitals. Our results show the importance of controlling for unobserved patient heterogeneity when comparing quality ofpublic and private hospitals.

KW - ownership

KW - hospital

KW - quality

KW - choice

KW - distance

KW - Endogeneity

M3 - Discussion paper

T3 - CHE Research Paper

SP - 1

EP - 34

BT - The effect of hospital ownership on quality of care

PB - Centre for Health Economics, University of York

ER -